| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,967 |
2,724 |
$143K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,077 |
1,072 |
$36K |
| 87428 |
|
325 |
320 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
133 |
131 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
107 |
107 |
$6K |
| 92551 |
|
629 |
628 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
58 |
58 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
52 |
52 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
511 |
506 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
426 |
414 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
43 |
42 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
37 |
37 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
99 |
99 |
$2K |
| 81000 |
|
419 |
408 |
$944.68 |
| 99402 |
|
268 |
267 |
$895.75 |
| 87081 |
|
250 |
246 |
$806.38 |
| 87184 |
|
243 |
239 |
$659.77 |
| 99173 |
|
358 |
357 |
$597.55 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
13 |
12 |
$311.90 |
| 81003 |
|
193 |
190 |
$294.47 |
| 90461 |
|
13 |
13 |
$235.45 |
| 96160 |
|
84 |
82 |
$148.17 |
| 99401 |
|
267 |
266 |
$62.50 |
| 99000 |
|
147 |
141 |
$3.35 |
| 99072 |
|
15 |
15 |
$0.00 |